Associations between individual and structural level discrimination and psychological and physiological stress indicators during pregnancy

In the United States (U.S.) pervasive health disparities in prenatal care disproportionately impact marginalized individuals. The present study investigates whether discrimination at the individual and structural levels are associated with indicators of psychological and physiological stress among pregnant Latinx people living in the U.S., including both U.S. and foreign-born individuals. Pregnant participants ( n = 109) reported on birthplace, lifetime experiences of racial and ethnic discrimination, perceived levels of stress, acculturation, social support, and provided residential address data and hair samples for cortisol analysis. Regression analysis revealed that individual level discrimination was linked to higher psychological stress during pregnancy ( p = .003), and structural level discrimination was related to lower physiological stress (cortisol; p = .056). Notably, these associations varied by birthplace: U.S.-born individuals showed higher levels of psychological stress in response to individual level discrimination, while foreign-born individuals appeared more resilient to structural level discrimination. The results are discussed within the framework of immigrant health paradox.